Nicole Saphier, MD: Kamala Harris flip-flops on 'Medicare for All' – Will Americans buy her latest plan?

Democratic presidential candidate Sen. Kamala Harris revealed her plan to achieve universal health care on Monday in an essay on Medium declaring, “Medicare works. Now, let’s expand it to all Americans and give everyone access to comprehensive health care.”

Her plan aims to expand Medicare with the help of private insurers. That’s a major change from her previous statements and positions. But is anyone surprised that Harris has changed her political song and dance on this issue? Still, it’s quite a turnaround from her previous positions.

In August 2017, Harris became the first Senate Democrat to support fellow Senator Bernie Sanders' “Medicare for All” bill.

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At a town hall in early 2019 the California Democrat reaffirmed her pledge to eliminate all private health care insurance for approximately 150 million Americans if elected president.

Then she turned around and walked that pledge back after suffering backlash over the issue. She explained the change of heart by saying that what she meant was that she would get rid of insurance company the red tape and not necessarily private insurance.

Yet in June, Harris and Sanders were the only two presidential hopefuls to raise their hands during the first Democratic debate when all the candidates were asked who was in favor of doing away with private health insurance in favor of a government-run option.

The leading Democratic candidates are pushing their single-payer agenda so hard that they are not acknowledging the 73 percent of adults Americans who don’t want private health insurance to go away.

Now with the next debate fast approaching this week, she'll be on the debate stage on Wednesday in Detroit, she is changing her tune again.

Under Harris’ new plan private insurance would have a larger role to play in delivering health care than under Sanders' plan.

Harris now proposes a system that would function much like the current Medicare structure, in which people can either buy into government-administrated Medicare plans or choose from government-approved private companies, also known as Medicare Advantage.

Medicare Advantage is the most popular version of Medicare offering a combination of government and private coverage. It is one of President Trump’s latest missions and is currently seeing huge expansions across many states following federal rules changes that allow plans to offer more benefits.

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Health and Human Services Secretary Alex Azar recently implied that Medicare Advantage plans could see pay increases as part of the Trump administration's policy to tackle maternal mortality rates and social determinants of health and rural health care access.

All of this is being rolled out with the Senate bill's proposal to cap price increases within Medicare Part D and following an Executive Order regarding price transparency confirming that insurance companies will be required to provide patients with information about out-of-pocket costs before they receive services, rather than weeks later when they get the bill.

Sanders, Sen. Cory Booker, Harris and Elizabeth Warren are all preaching to a small minority of Americans that Sanders’ “Medicare for All” plan will solve the nation’s health care woes because it will cover ALL Americans (and apparently illegal immigrants according to the hand-raising polling at the last debate). What they fail to acknowledge is that according to the National Center for Health Statistics over 90 percent of Americans already have health insurance and half of those who don’t have coverage actively choose not to get it.

The perceived support of the proposed “Medicare for All” plans collapses when people are told that the government would need to do a complete overhaul of our health care system and negate all existing private health insurance plans to implement it, not to mention the hefty tax increase that would occur overnight on everyone (lower- and middle-class Americans included) and then steadily rise upon implementation.

The leading Democratic candidates are pushing their single-payer agenda so hard that they are not acknowledging the 73 percent of adults Americans who don’t want private health insurance to go away. Rather they want to focus on increased access to care, more choices in the insurance market and overall lower costs of health care.

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Frontrunner Joe Biden has been the only Democrat, so far, to not fall prey to the single-payer outcry because he is the lone candidate in his party who has experience in this arena and isn’t just playing political roulette during the primary season.

Biden witnessed the difficulty of pushing through the Affordable Care Act and the resistance that followed from the American people. He knows that the only way for a Democrat to even stand on the same debate stage with President Trump during the general election campaign is to offer voters a plan that includes private health insurance.

So, is Harris following Biden’s lead in her latest health care flip flop? Is she going beyond the Affordable Care Act and unintentionally endorsing the Trump administration’s efforts to expand Medicare Advantage? The president is not only expanding access, he is taking measures to lower the cost of care; the pièce de résistance that remains missing in Sanders’ and Harris’ plans.

How much will Harris’ plan ultimately cost, and will her tax hikes cover it? The current Medicare Advantage plans limit payments to doctors and hospitals to the abysmal traditional Medicare rates which are offset by the higher reimbursement of the privately insured.

Although this song and dance sounds like a deviation from single-payer health care, if Harris’ plan goes forward without refuting the Medicare Advantage reimbursement scheme, this will be another version of proposed government-run health care that further exacerbates limited access to care and lack of physician access.

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The time is now for Harris to explain how this strategy will bring American health costs down because nothing in the essay on Medium mentions it.  Harris simply states that it would decrease costs, but her initial plan did not offer details explaining how.

So just as when Barack Obama famously said in 2009, “if you like your health care plan, you'll be able to keep your health care plan," are we now expected to blindly trust Harris, knowing her promises will be just another empty political promise?

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